高脂血症性急性胰腺炎130例

Clinical features of hyperlipidemic acute pancreatitis: An analysis of 130 cases

目的:总结分析高脂血症性急性胰腺炎(hyperlipidemic acute pancreatitis,HLAP)患者的临床特点.方法:对2006-01/2012-09月住院诊治的HLAP患者进行回顾性分析,对其临床资料等进行统计分析,并选择100例胆源性急性胰腺炎(acute biliary pancreatitis,ABP)患者作为对照组进行对比.结果:共102例患者130次发生HLAP,占全部急性胰腺炎(acute pancreatitis,AP)患者的17.4%.重症患者占23.1%.HLAP患者发病年龄、血清淀粉酶>3倍正常值比例均低于均高于ABP患者(P<0.05),而糖尿病、脂肪肝、既往AP发作史比例均高于ABP组(P<0.05).甘油三酯(triglyceride,TG)≥11.30mmol/L的HLAP患者血清淀粉酶>3倍正常值比例低于TG值5.65-11.30mmol/L的患者(23.4%vs41.5%,P<0.05),而重症HLAP比例、住院时间、腹痛持续时间无统计学差异(P>0.05).结论:HLAP患者发病年龄低、男性多见,多有代谢综合症表现,具有显著的复发性趋势,血清淀粉酶增高不明显,TG水平与临床严重程度不相关.

AIM： To summarize and analyze the clinical features of hyperlipidemic acute pancreatitis （HLAP）. METHODS： Clinical data for patients with HLAP treated at our hospital from January 2006 to September 2012 were analyzed retrospectively. The clinical characteristics of HLAP were statistically analyzed. One hundred patients with acute biliary pancreatitis （ABP） were enrolled as controls. RESULTS： A total of 102 HLPA patients （130 onsets） were enrolled in this study, accounting for 17.4 % of all AP patients. Patients with severe HLAP accounted for 23.1% of all HLAP patients. The mean age and percentage of patients with a serum amylase level greater than 3 times the upper limit of normal were significantly lower in HLAP patients than in ABP patients （both P〈0.05）; however, HLAP patients were more likely to be associated with underlying metabolism syndrome and history of acute pancreatitis （both P〈0.05）. The percentage of patients with a serum amylase level greater than 3 times the upper limit of normal was lower in HLAP patients with a TG level greater than or equal to 11.30 mmol/L than in HLAP patients with a TG level between 5.65-11.30 mmol/L （23.4% vs 41.5%, P〈0.05）, but there were no significant differences in the proportion of severe cases （21.7% vs 28.6%, P〈0.05）, hospitalization time （13.1 d ± 6.2 d vs 14.4 d ± 7.9 d, P〈0.05）, and duration of abdominal pain （2.43 d ± 1.6 d vs 2.08 d ± 1.8 d, P〈0.05） between HLAP patients with different TG levels. CONCLUSION： Low age of disease onset, male predominance, close relationship with metabolism syndrome, easy to recur, and unobvious increase in serum amylase are main clinical features of HLAP. Serum TG levels do not correlate with the severity of HLAP.